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Sample Web Form

NOTE: This sample form is NON-FUNCTIONAL and should be used ONLY for purposes of identifying code structures and observing a sample form layout. Item numbers are for reference only.

1 <FORM METHOD="post" ACTION="http://">
2 Name:
  E-mail Address:
in form of jsmith@iupui.edu
  Work Phone Number:
  Mailing Address:
3 What is your favorite ice cream flavor (choose only one)
Vanilla
Chocolate
Strawberry
Other—Identify:
4 Do you have a
5 How did you discover your favorite place(s) to eat ice cream?
(check all that apply)

Cindy Word-of-Mouth Ice Cream Man Drove By
Neighborhood Kid—Please identify:
6 Please add any additional comments or explanation that you desire:
7   

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